Causes of Heart Failure in Young Adults

Heart failure in young adults may result from heart muscle disease, inflammation, rhythm problems, congenital heart conditions, valve disease, or long-standing high blood pressure. Sometimes several factors affect the heart together, and sometimes the cause remains unclear after initial tests. Heart failure means the heart is not pumping or filling well enough to meet the body's needs; it does not mean that the heart has stopped.

Cardiomyopathy is disease of the heart muscle. The muscle may become enlarged, stiff, stretched or weakened, which can interfere with pumping or filling. Myocarditis is inflammation of the heart muscle and may follow an infection or occur through an immune reaction. An abnormal rhythm, including atrial fibrillation or a persistently very fast heartbeat, can reduce efficient pumping over time.

A congenital heart problem may have been present from birth but only become troublesome later. A damaged or abnormal valve can also make the heart work harder. Hypertension increases the force against which the heart pumps; when it is untreated for a long time, the heart can become thick or less flexible. A clinician may also ask about family history, prescribed medicines, alcohol or recreational drugs, because these details can help identify a trigger or inherited risk.

Arrange a medical assessment if you have new or worsening breathlessness, unusual fatigue, a persistent cough, palpitations, or swelling around the ankles. The assessment may include questions about the timeline of symptoms, an examination, blood pressure measurement, an electrocardiogram, blood tests and an echocardiogram. Depending on the findings, a clinician may recommend additional imaging or rhythm monitoring.

Bring a list of medicines and supplements, and mention recent infections, fainting, chest discomfort, pregnancy or a family history of cardiomyopathy or sudden cardiac death. Do not stop prescribed heart or blood-pressure medicine without medical advice. Until you have been assessed, avoid using recreational stimulants and ask whether strenuous exercise is appropriate for you.

Seek emergency help for severe or rapidly worsening breathlessness, breathlessness at rest, fainting, new severe chest pain, blue or grey lips, confusion, or a fast or irregular heartbeat accompanied by dizziness. These symptoms can signal a serious problem with oxygen flow or heart rhythm and should not wait for a routine appointment.

If ankle swelling, fatigue or cough is gradually worsening, contact a clinician promptly even when you are young. A symptom does not identify its cause by itself, so timely examination and testing are safer than trying to diagnose heart failure from symptoms alone.

Ask what type of heart failure is suspected, which test results support that view, and whether an abnormal rhythm, valve problem, inflammation or inherited heart-muscle condition needs checking. You can also ask which activities are suitable now, which symptoms should prompt urgent help, and whether close relatives should discuss their own heart health with a clinician.